Analgesic effect of intra-articular bupivacaine or diamorphine after arthroscopic surgery of the knee joint in day-case patients.
A prospective, randomized, double-blind, controlled study was conducted to assess the efficacy of intra-articular bupivacaine and diamorphine. Ninety-six day-case patients were allocated randomly to receive intra-articular injections of either 20 mL 0.9% saline (control, n = 35), 20 mL 0.5% plain bupivacaine (n = 31), or 20 mL 0.9% saline with 5 mg diamorphine (n = 30) prior to tourniquet release. Visual analogue scales (VAS) were completed at 1 h, 3 h (discharge) and 24 h, and supplementary analgesia noted. Intra-articular analgesics conferred a noticeable improvement in patient comfort. First, the quantity of supplementary analgesia required prior to discharge was significantly reduced (P = 0.016); second, patients reported a less disturbed night's sleep (P = 0.034).
Shaw
A
A
Trafford General Hospital, Trafford Healthcare NHS Trust, Davyhulme, Manchester, UK.
Mobbs
P J
PJ
Haines
J F
JF
Rao
S
S
O'Connor
M
M
D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000009:adverse effects; D001182:Arthroscopy; D002045:Bupivacaine / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D003932:Heroin / Q000008:administration & dosage; D006801:Humans; D007270:Injections, Intra-Articular; D020910:Ketorolac; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects; D014046:Tolmetin / Q000031:analogs & derivatives / Q000627:therapeutic use
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D003932:Heroin; D014046:Tolmetin; D005283:Fentanyl; D002045:Bupivacaine; D020910:Ketorolac